scholarly journals Knee arthroplasty for acute fractures around the knee

2020 ◽  
Vol 5 (10) ◽  
pp. 713-723
Author(s):  
Thomas Tampere ◽  
Matthieu Ollivier ◽  
Christophe Jacquet ◽  
Maxime Fabre-Aubrespy ◽  
Sébastien Parratte
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Femur ◽  
Weight Bearing ◽  
Young Patients ◽  
Revision Arthroplasty ◽  
Patient Specific ◽  
Full Weight Bearing ◽  
Articular Fractures ◽  
Primary Arthroplasty

Results of open reduction and internal fixation for complex articular fractures around the knee are poor, particularly in elderly osteoporotic patients. Open reduction and internal fixation may lead to an extended hospital stay and non-weight-bearing period. This may lead to occurrence of complications related to decubitus such as thrombo-embolic events, pneumonia and disorientation. Primary arthroplasty can be a valuable option in a case-based and patient-specific approach. It may reduce the number of procedures and allow early full weight-bearing, avoiding the above-mentioned complications. There are four main indications: 1) Elderly (osteoporotic) patients with pre-existing (symptomatic) end-stage osteoarthritis. 2) Elderly (osteoporotic) patients with severe articular and metaphyseal destruction. 3) Pathological fractures of the distal femur and/or tibia. 4) Young patients with complete destruction of the distal femur and/or tibia. The principles of knee (revision) arthroplasty should be applied; choice of implant and level of constraint should be considered depending on the type of fracture and involvement of stabilizing ligaments. The aim of treatment is to obtain a stable and functional joint. Long-term data remain scarce in the literature due to limited indications. Cite this article: EFORT Open Rev 2020;5:713-723. DOI: 10.1302/2058-5241.5.190059

scholarly journals Hip dislocation following the treatment of femoral neck fracture: Case report

2010 ◽  
Vol 138 (3-4) ◽  
pp. 248-251
Author(s):  
Zoran Vukasinovic ◽  
Igor Seslija ◽  
Borislav Dulic
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Young Patients ◽  
Hip Dislocation ◽  
Full Weight Bearing ◽  
Limited Range Of Motion ◽  
Femoral Head Osteonecrosis ◽  
Neck Fracture

Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

Distal femoral osteotomy for genu valgum deformity caused by malunited Hoffa fracture

2021 ◽  
Vol 14 (2) ◽  
pp. e238615
Author(s):  
Taiga Oda ◽  
Akira Maeyama ◽  
Tetsuro Ishimatsu ◽  
Takuaki Yamamoto
Keyword(s):  
Internal Fixation ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Young Patients ◽  
Femoral Osteotomy ◽  
Posterior Aspect ◽  
Distal Femoral Osteotomy ◽  
Non Union ◽  
Hoffa Fracture ◽  
Articular Fractures

Hoffa fractures are unstable intra-articular fractures of the femoral condyle that occur in the coronal plane.Insufficient anatomical reduction and internal fixation may lead to non-union or malunion. A 39-year-old man was involved in a traffic accident while riding a motorcycle and was diagnosed with left Hoffa fracture and avulsion fracture of the femoral attachment of the medial collateral ligament. Open reduction and internal fixation were performed 5 days after injury. The patient experienced intermittent knee pain, joint contracture and deformity, and attended our hospital for further treatment 18 months after surgery. CT revealed depression and malunion of the posterior aspect of the lateral femoral condyle, and weight-bearing X-ray showed valgus deformity due to malunion. Distal femoral osteotomy (DFO) was performed and good functional and radiographic results were obtained. This report suggests that DFO is a reasonable treatment for young patients suffering from malalignment due to malunited Hoffa fracture.

scholarly journals Treatment of subtrochanteric fracture femur by open reduction and internal fixation by long proximal femoral nailing

2019 ◽  
Vol 6 (1) ◽  
pp. 164
Author(s):  
Prabhu P. Munavalli ◽  
Gururaj N. G.
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Road Traffic ◽  
Weight Bearing ◽  
Subtrochanteric Fracture ◽  
High Rate ◽  
Full Weight Bearing ◽  
Subtrochanteric Fractures ◽  
Fractures In Children ◽  
Pathologic Fractures

<p class="abstract"><strong>Background:</strong> Subtrochanteric fractures are devasting injuries that most commonly affect the elderly population and also in young.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 20 cases of subtrochanteric fracture admitted to KIMS, Huballi between November 2008 to August 2010 treated with left proximal femoral nail (LPFN) by open method. Cases were taken according to inclusion and exclusion criteria, i.e., fresh subtrochanteric fracture in adults. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study. Objectives of this study were to study subtrochanteric fractures and to determine effectiveness of LPFN in tretment of subtrochanteric fractures by open reduction and internal fixation (ORIF).<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study of 20 cases, there were 16 male and 4 female patients with age ranging from 17 years to 75 years with most patients in between 21-40 years. 65% of the cases admitted were road traffic accidents, 25% due to fall from height and 10% due to trivial fall with right side being more common side affected. Russell and Taylor type IA fracture accounted for 40% of cases. Mean duration of hospital stay was 24 days and mean time of full weight bearing was 14 weeks in our patients. Good to excellent results were seen in 85% of cases in our study.</p><p class="abstract"><strong>Conclusions:</strong> Subtrochanteric fractures of femur can be successfully treated by ORIF by LPFN resulting in proper anatomical reduction and hence alignment and high rate of bone union.</p>

scholarly journals Study on functional outcome of bimalleolar ankle fractures treated by open reduction and internal fixation

2021 ◽  
Vol 7 (3) ◽  
pp. 518
Author(s):  
Nithin Gangadhran ◽  
Manju G. Pillai
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
External Rotation ◽  
Outcome Measurement ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Cortical Screw ◽  
Articular Fractures ◽  
Prospective Longitudinal

<p class="abstract"><strong>Background:</strong> Ankle injury is the most common weight bearing orthopaedic musculoskeletal trauma encountered in emergency medicine and practice. Ankle joint is highly congruous and any disturbance of normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. As with all intra-articular fractures it necessitates accurate reduction and stable internal fixation. The objectives were to study the functional outcome of surgical treatment of bimalleolar ankle fractures and to know the complications of open reduction internal fixation of bimalleolar fractures.</p><p class="abstract"><strong>Methods:</strong> 45 patients with malleolar fractures were included in this prospective longitudinal interventional study. Patients who underwent operative treatment were followed up regularly for 6 months with OPD visits and X-ray imaging at each stage. Patient parameters were recorded at immediate post op period, 6 weeks, 12 weeks and 24 weeks. Baird and Jackson scoring system for ankle were used for the functional outcome measurement.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most common type of injury pattern was supination-external rotation with 21 cases (47% of cases). The results are excellent to good in 65% of patients, 27% of patients had fair and 8% had poor result. Syndesmotic screw fixation was done with 4.5 mm cortical screw in 7 cases. Most common complication was surgical site infection in 3 cases (6.67%). 2 patients underwent implant removal due to unresolved infection at 3 months.</p><p class="abstract"><strong>Conclusions:</strong> The results of operative fixation were satisfactory in 90% of patients. Most of the complications were minor and resolved within three weeks.</p><p class="abstract"> </p>

Fractures of the Calcaneus: Open Reduction and Internal Fixation From the Medial Side a 21-Year Prospective Study

1997 ◽  
Vol 18 (11) ◽  
pp. 685-692 ◽  
Author(s):  
Billie D. Burdeaux
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Medial Approach ◽  
Medial Side ◽  
Successful Group ◽  
American Orthopaedic ◽  
System Time

Since 1974, 61 displaced fractures of the calcaneus have been treated by open reduction and internal fixation by a modified medial approach technique. Surgery was performed through a 5-cm incision posterior to the neurovascular bundle. A single threaded pin was passed longitudinally through the tuberosity and into the sustentacular fragment, giving stable fixation. Reduction of the depressed posterior facet fragments was accomplished from the medial side in 77% of cases, occasionally assisted by fluoroscopy. Postoperatively all fractures were immobilized in a cast for 4 weeks. At the end of 4 weeks the pin was removed, and full weight bearing in a walking cast was started and continued for 4 weeks. At 8 weeks after surgery, the walking cast was removed, and the patient began walking in a shoe. These cases were evaluated at a mean follow-up of 4.4 years. There were 49 successful cases (80.3%) and 12 unsuccessful cases (19.7%). A high number of superior results was found in the successful group as shown by the mean score of 94.7 (American Orthopaedic Foot & Ankle Society Scoring System). Time to return to work was a mean of 4.9 months.

scholarly journals Study of outcome of knee joint in patients with fracture distal femur versus fracture ipsilateral femur and tibia

2021 ◽  
Vol 12 (2) ◽  
pp. 1174-1181
Author(s):  
Ravindra B Gunaki ◽  
Chitresh Mehta ◽  
Rahul Sharma ◽  
Swapnil Chitnavis
Keyword(s):  
Knee Joint ◽  
Distal Femur ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Bony Union ◽  
Fracture Femur ◽  
Articular Fractures ◽  
Stay Time ◽  
A Prospective Study ◽  
Type Of Fracture

The posture on the two wheeler at the speed we travel, makes knee the vulnerable joint of all in any of the mishaps. We as orthopedic surgeons see the fractures around the knee joint as one of the most studied concept in the subject. This is a prospective study conducted, over 2 years, in Krishna Institute of Medical Sciences, Deemed to be University, Karad. In this study, 20 cases of fracture distal femur and 20 cases of ipsilateral fracture femur and tibia were studied to evaluate outcome of knee joint and post surgical stabilization of fractures. The fractured limb was stabilized with splinting the limb in Thomas splint or plaster slab. The type of fracture, type of fracture fixation, duration of hospital stay, time of union and time to start weight bearing are evaluated. According to Neer’s score, Good outcome was found in both Fracture Distal femur and Ipsilateral Fracture Femur and tibia. The functional outcome was found to be better in diaphyseal fractures femur and tibia treated with intramedullary interlock nailing which allowed early mobilization and weight bearing than in intra-articular fractures treated with plating. Bony union occurred early in closed, diaphyseal and simple transverse or oblique fractures and delayed in open, intraarticular and comminuted fractures. 

scholarly journals Intercalary reconstruction of femur after tumour resection: is a vascularized fibular autograft plus allograft a long-lasting solution?

2018 ◽  
Vol 100-B (3) ◽  
pp. 378-386 ◽  
Author(s):  
D. A. Campanacci ◽  
F. Totti ◽  
S. Puccini ◽  
G. Beltrami ◽  
G. Scoccianti ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Young Patients ◽  
Bone Tumour ◽  
Full Weight Bearing ◽  
Tumour Resection ◽  
Fibular Graft ◽  
Musculoskeletal Tumor Society ◽  
Long Term Outcome ◽  
The Mean

Aims After intercalary resection of a bone tumour from the femur, reconstruction with a vascularized fibular graft (VFG) and massive allograft is considered a reliable method of treatment. However, little is known about the long-term outcome of this procedure. The aims of this study were to determine whether the morbidity of this procedure was comparable to that of other reconstructive techniques, if it was possible to achieve a satisfactory functional result, and whether biological reconstruction with a VFG and massive allograft could achieve a durable, long-lasting reconstruction. Patients and Methods A total of 23 patients with a mean age of 16 years (five to 40) who had undergone resection of an intercalary bone tumour of the femur and reconstruction with a VFG and allograft were reviewed clinically and radiologically. The mean follow-up was 141 months (24 to 313). The mean length of the fibular graft was 18 cm (12 to 29). Full weight-bearing without a brace was allowed after a mean of 13 months (seven to 26). Results At final follow-up, the mean Musculoskeletal Tumor Society Score of 22 evaluable patients was 94% (73 to 100). Eight major complications, five fractures (21.7%), and three nonunions (13%) were seen in seven patients (30.4%). Revision-free survival was 72.3% at five, ten, and 15 years, with fracture and nonunion needing surgery as failure endpoints. Overall survival, with removal of allograft or amputation as failure endpoints, was 94.4% at five, ten, and 15 years. Discussion There were no complications needing surgical revision after five years had elapsed from surgery, suggesting that the mechanical strength of the implant improves with time, thereby decreasing the risk of complications. In young patients with an intercalary bone tumour of the femur, combining a VFG and massive allograft may result in a reconstruction that lasts a lifetime. Cite this article: Bone Joint J 2018;100-B:378–86.

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